Discordance between clinical and post-mortem diagnoses at a tertiary hospital

Abstract

Advances in modern medicine and more accurate and precise diagnostic procedures have been considered to be the main reason for the reduction in autopsy rates. However, there is still a discrepancy between clinical and autopsy diagnoses. This retrospective study, designed as a cross-sectional study, included a sample of 931 patients who died at the Clinical Hospital Centre ‘Zemun’. We analysed sex, age, length of hospitalisation and clinical and post-mortem diagnoses, including the discrepancies between them. In 314 (34%) cases, there was complete agreement between the clinical and autopsy diagnoses, complete disagreement in the same percentage and incomplete agreement in 303 (32%) cases. In people aged >60 years, the risk of misdiagnosis was 2.5-fold higher than in the those aged <60 years (odds ratio (OR)=2.522, p<0.001), while the influence of sex on the risk of misdiagnosis was not statistically significant (OR=0.981, p>0.05). An increase in the number of autopsies would be one of the best methods to make discrepancies between clinical and post-mortem diagnoses visible, and a good method for continuous evaluation of diagnostic tests, as well as for providing a wider perspective on presentations of different clinical conditions.